RUM II Project as an enabler to
digital signature and eID in
healthcare
Marek Ujejski
Deputy Director IT Department National Health Fund, POLAND
Member of eIDAS Expert Group – DG CONNECT
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
Landscape of Poland 1
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
Landscape of Poland 2
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
Landscape 3
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
POLAND – some facts
Area
Quantity of
citizen
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
Status of NFZ
Information Society and e-Government in Digital Era
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Warsaw 2nd June 2015
POLAND – some facts
Quantity of
medical units
Refund cost
of medical
treatments
2014 Year
Insurance expenditure as overall
versus GBP per capita
Wydatki KCh/NFZ (mln zł)
60 000
PKB na jednego mieszkańca (mln zł)
50 000
40 000
30 000
Differential
2010 58%
20 000
10 000
Differential
1999 40%
Source: GUS 2011, NFZ 2014
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
How polish healthcare is percived ?
http://www.healthpowerhouse.com/
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
What about patient access to own data ?
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
Main obstacles in getting access
to the medical data
Lack of eHR
 Lack of enough secure tools (eID means)
 Diversity of legal regulation in MS EU
 Diversity of sensitive data treatment in MS
 Diversity of technical solution
 Data formats –crossborder issues

Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
Author: Jerome Boehm DG SANCO,
Workshop on eHealth 24th September 2013 Brussels
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
epSOS II countries
 20 UE MS
 3 non UE MS
Active
Passive
EPSOS – European Patients Smart Open Services
Recital (10) eIDAS Regulation

Directive 2011/24/EU of the European Parliament and of the Council
of 9 March 2011 on the application of patients’ rights in cross-border
healthcare1 sets up a network of national authorities responsible for
eHealth. To enhance safety and the continuity of cross-border
healthcare, the network is required to produce guidelines on crossborder access to electronic health data and services, including by
supporting ‘common identification and authentication measures to
facilitate transferability of data in cross-border healthcare’. Mutual
recognition and acceptance of electronic identification and
authentication is key to make cross border healthcare for European
citizens a reality. When people travel for treatment, their medical
data needs to be accessible in the country of treatment. This
requires a solid, safe and trusted electronic identification framework.
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
Backbone of system
1.
2.
3.
4.
5.
Public Key Infrastructure
Card Management Systems (CAMS)
Primary Registers
Database of Healthcare Unit
Database of National Health Fund
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
How we approach to problem…







Cards as a tools in administrative and medical
part of healthcare
Electronic Health Insurance Card (eHIC)
Health Professionals Card (HPC)
Administrative Professional Cards (APC)
Card as a data carrier – old approach
Card as a key – new approach
Mixed role –newest aproach
Lokal components of system
1.
2.
3.
4.
5.
Cards (plus software)
Reader
Workstation (plus software)
4
Patient
Professional
1
2
3
5
How system RUM II works –basic flow
XML
Serwer
lokalny
XML
XAdES KUZ
1. Terminal verification (TA) due to EN 14890-2
2. Chip verification
(CA) due to EN 14890-2
3. Card to Card Authentication
4. Patient insurance status (e-WUŚ)
5. Create document (medical description)
6. Electronic signature ( KUZ)
PKI
7. Professional signature (KSM)
8. XML document (signed) stored locally
9. Reimbursement raport send to NFZ
Information Society and e-Government in Digital Era
XML
INTERNET
The Danish and the Polish experience,
XAdES KUZ
XAdES KSM
E-WUŚ
CWU
Warsaw 2nd June 2015
How to use eID function ?
Country B
Country A
I
N
T
E
R
N
E
T
Data base
contain eHR
Patient
OK
Authentication
modul
X
Failed
Authorisation
module for
system
How to improve ?
Country B
Country A
HUB
B
Authentication
Services Level H
I
N
T
E
R
N
E
T
HUB
A
Information Society and e-Government
in Digital Era
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Data base
contain eHR
Patient
OK
Authorisation
module for
system
HIC (EKUZ) key function




Electronic signature (1st key pair, no PIN)
Electronic identification (2nd key pair, PIN required)
Electronic signature (3rd key pair, PIN required)
Carrier for:



Administrative data
Emergency data (on demand)
Graphical layer
Information Society and e-Government in Digital Era
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Warsaw 2nd June 2015
HPC (KSM) main function
Electronic signature (PIN, PIN required)
 Electronic identification (2nd key pair, PIN
required)
 Access to emergency data on patient card
based on CVC (not for all staff)
 Carrier for:

 Administrative
data
 Qualification status (not for all proffesionals)
Project schedule
Source: European Commission
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
Conclusion
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015
Information Society and e-Government in Digital Era
The Danish and the Polish experience,
Warsaw 2nd June 2015